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Posted by MLWhitworth, MD
on March 27, 2000 at 07:01:00:
In Reply to: pseudoaddiction posted by ila on March 26, 2000 at 21:20:40:
Pseudoaddiction is undermedication by the physician due to his unwillingness to use higher narcotic doses secondary to unwarranted addiction concerns, lack of education regarding narcotics, or concerns about his licensure. This causes predictable behavior in patients of "drug seeking". Of course if side effects become intractable, then the appropriate narcotic dose may never be reached.
Ally has possibly received her information regarding methadone from an addiction clinic who's staff is generally completely uneducated about chronic pain. These clinics emphasis is on withdrawal of all narcotics from former heroin addicts. They fail to see the difference in treating heroin addiction and chronic pain with methadone...they blaim the drug for all the ills of the world rather than the condition leading to heroin addiction in the first place. The addiction potential of chronic pain patients is very low, less than 1%. Also remember, these drug rehab clinics are staffed with addiction specialists whose emphasis is drug free, whether that is medically indicated or not. They peddle their services at the rate of thousands of dollars per week but fail to ever address whether chronic pain can be treated with narcotics...their answer is simply drug free period. Not realistic for all patients....they play on the patient's fears of the use of methadone.
: Dear Dr. Whitworth, hope this post finds you in good health.
: Read your post to JohnV and Ally's notes and subsequent reposts. You say that the Dr's inadequate medication drops result in the paradox "pseudoaddiction".
: I'm confused - are you saying that that Dr's cause extra problems to the pain sufferer by under medicating them, as a result, the pain sufferer looks to other Dr's for pain meds and end up an addict because they're taking a whole lot of different meds??
: Or is the pain sufferer too scared to come off the meds they're on because their needs have never been met for so long that what they're really feeling are phantom pains?
: How would a rehab clinic know this? Shouldn't Ally be receiving counselling before she enters the clinic?
: How can this be allowed to happen in this day and age?
: take care, ila